Elon Musk tweeted about 50 cognitive biases everyone should learn.
It’s a thought-provoking list.
But the infographic (see below) is difficult to digest.
@M_El_Sheikh
#neurosurgery #decisionmaking
Decision-making is a key but under-discussed component of neurosurgery.
I’ve re-summarized the 50 cognitive biases Musk recommends to learn.
Each has it’s own neurosurgery example drawn from experience.
Today I’ll share the first 25, tomorrow the second half.
@MDCearns
First, a quick note about cognitive biases.
What are they?
Why is knowing about them crucial?
All humans make systematic errors in thinking—hurting our judgment.
Being aware of cognitive biases will make you less susceptible to them.
Let’s get started.
Fundamental Attribution Error
We judge everyone else on character but blame our shortcomings on the situation.
Example: Your FY2 is late for work, so he’s lazy. If you’re late for work, it’s because of traffic.
Self-Serving Bias
We chalk failures up to the situation while taking all the credit for our successes.
Example: You cured the patient’s leg pain with your microsurgical skill. Meanwhile, their wound broke down because the ward isn’t clean.
Ingroup Favoritism
We privilege those in our ingroup over those in an outgroup.
Example: Simon works in neurosurgery, so you value his opinion more than Anna, who works over in orthopaedics.
Bandwagon Effect
Concepts, trends, and beliefs catch on as more people validate them.
Example: Everyone wants to use the new Kinevo microscope that’s on demo, even though it’s just the same as the Zeiss.
Groupthink
We make irrational decisions just to avoid conflict.
Example: You put the infected case at the start of the list because the patient has complained in the past.
Halo Effect
Focusing on one trait (positive or negative) as being indicative of the whole.
Example: Michael must be a great surgeon because he went to Oxford.
Moral Luck
Equating moral superiority with a positive outcome and moral inferiority with a negative outcome.
Example: He’s a prisoner so it’s not surprising he got a post-op complication.
False Consensus
We assume others agree with us by default.
Example: “Obviously this patient wouldn't want an operation because of their age.”
Curse of Knowledge
We believe that everyone knows the same things we do.
Example: You get pissed off at another “CES” referral that has no back or leg pain.
Spotlight Effect
We think people are paying far more attention to us than they are.
Example: You miss some calls on the on call phone because you’re busy and now imagine the CMO is on the phone to your consultant.
Availability Heuristic
We make snap judgments based on the most recent information.
Example: Drop in GCS = needs CT scan.
Defensive Attribution
The tendency to blame others for your mistakes out of self-protection.
Example: “I opened the wrong side of the head, because no one stopped me at the time out to say I was pointing at the wrong side.”
Naïve Cynicism
The assumption that others act only out of self-interest.
Example: "The only reason the medics are referring this patient, are to cover their own backs.”
Forer Effect (aka Barnum Effect)
We see ourselves reflected in things that could apply to many.
Example: “Neurosurgeons are very hard working.”
Dunning-Kruger Effect
The overestimation of ability when one has little experience.
Example: You are now on the on call registrar and believe lumbar microdiscectomies are easy cases.
Anchoring
We make decisions based on first impressions.
Example: “It’s a consultant referring a patient. This is will be straight-forward” (never is).
Automation Bias
We put too much trust in automated systems to fix our mistakes.
Example: BrainLab/STEALTH said do the burr hole here for a shunt (on sagittal sinus)
Google Effect (aka Digital Amnesia)
We don’t store information in our brains that’s conveniently found online.
Example: “What’s the dose of mannitol…?”
Reactance
We go against orders, especially when we see them as an assault on our freedoms.
Example: “I’m not going to touch the patient so why do I need to wear a pinny, gloves and visor?!”
Confirmation Bias
We seek out (and retain) information that confirms what we already believe.
Example: Drains for CSDH are lethal. Points out single complication in 200 as proof.
Third-Person Effect
We see ourselves as more immune to media than others.
Example: “You shouldn’t worry about being sued so much.” Then documents 3 pages in the notes for every CES patient.
Belief Bias
We tend to accept the outcome of an argument only if it matches what we believe.
Example: TBI causes oedema. Steroid reduce oedema. Therefore steroids are treatment for TBI.
Backfire Effect
You interpret evidence that disproves your belief as a confirmation of it.
Example: A patient you didn’t want to operate on gets better after a second opinion and surgery from a colleague. “See. They would have gotten better either anyway.”
Boom. 25 cognitive biases that everyone should know as it applies to neurosurgery.
If you learned something, please RT the first tweet.
Understanding cognitive biases makes better neurosurgeons.
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